Have you been on hormone therapy for months (or even years) but still feel terrible? If you're dealing with brain fog, 3 AM wake-ups, energy crashes, and that stubborn weight around your middle despite being on HRT, this conversation is exactly what you need to hear.

I sat down with Dr. Jila Senemar, and honestly, this interview changed how I think about hormone optimization. We talked about why so many women are being undertreated, why your doctor might not be checking your levels, and what truly optimal hormone therapy looks like.

Are you ready to awaken your sensuality and feel more empowered in your body? Access the FREE Pleasure Upgrade Bundle at https://www.pleasureinthepause.com/gift.

Dr. Jila Senemar, M.D., FACOG is a board-certified obstetrician and gynecologist with over 20 years of experience who has become one of the leading voices in menopause optimization. She's the founder of JilaMD, a concierge practice in Miami specializing in personalized hormone therapy, metabolic optimization, and longevity science. Dr. Jila is also the founder of the Miami Menopause Collective, where she collaborates with women to create truly individualized treatment plans. What sets Dr. Jila apart is her commitment to helping women thrive—not just manage symptoms—in their second half of life through evidence-based, personalized care.

Highlights from our discussion include:

• The four pillars of HRT - estrogen, progesterone, testosterone, and vaginal estrogen - and why each one matters
• What to do when HRT isn't working - Dr. Jila's detective process for troubleshooting failed hormone therapy
• The controversial truth about hormone levels - why so many women are actually undertreated and what optimal ranges really look like
• How to personalize and optimize your protocol as your body evolves through different life stages
• The metabolic connection - cutting-edge insights on how hormones and metabolism work together
• The holistic approach - why lifestyle factors and emotional healing are just as important as the hormones themselves
• How to advocate for better care and ask the right questions to get the optimization you deserve

If you're seeking to reclaim your pleasure and vitality, join Gabriella at ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠www.pleasureinthepause.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ for this enlightening journey into the heart of female pleasure and empowerment.

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Dr. Mary Claire Haver

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This week, something extraordinary happened: menopause took center stage at the highest levels of US government in an unprecedented way. The US Food and Drug Administration (FDA) convened leading experts from across the country to discuss what millions of women have been waiting to hear: their experiences matter, their suffering is real, and there may be evidence-based solutions that have been withheld. This historic hearing offers tremendous hope for women navigating menopause.

Are you ready to awaken your sensuality and feel more empowered in your body? Access the FREE Pleasure Upgrade Bundle at https://www.pleasureinthepause.com/gift.

In this episode, we discuss:

• The End of Silence: Menopause, once a shamed and dismissed topic, has finally entered serious public discourse, moving beyond quiet endurance to high-level recognition.
• A Personal Story Driving Change: The head of the FDA shared his personal story about his mother who suffered greatly due to outdated fears around hormone therapy, emphasizing that bone fractures in older women can be fatal.
• Dismantling Dogma: Experts revealed that vaginal estrogen is categorically safe for all women, with no systemic absorption, directly challenging the black box warning.
• Brain and Bone Health: Researchers presented alarming data on how estrogen decline impacts brain function and bone density, emphasizing that hormone therapy can be a critical prevention tool, not just a treatment for the elderly.

This hearing signals a critical shift: women's health matters, our experiences are valid, and we deserve care based on current science, not outdated assumptions. Whether or not you choose hormone therapy, there is now hope that you can make informed decisions based on facts.

Your voice matters in this conversation!

The FDA is opening a public comment period on this topic. Please go to the FDA YouTube channel, listen to the full hearing, and leave your public comment. This is our opportunity to ensure today's expert testimony translates into policy changes that will help millions of women.

Help us spread more pleasure in the world!

Please subscribe, rate, and review this episode, and share it with someone you love. Your voice is crucial in creating ripples of pleasure and connection throughout our communities.

Until we meet again, remember, your pleasure matters.

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The conversation around menopause is finally being normalized, allowing us to openly discuss physical changes like hot flashes, brain fog, and sleepless nights. However, when it comes to our sexuality (describing shifts in desire, changes in intimacy, or articulating our sexual needs to partners) we often find ourselves speechless.

Reclaim your sensuality and step into a powerful new chapter. The Midlife Pleasure Collective is a monthly membership designed to help midlife women reconnect with their bodies, embrace their desires, and cultivate deeper pleasure.

Ever been awake at 3 AM, grappling with how to articulate bodily changes you don't fully grasp? Or frozen in a doctor's office when asked about your sexual health? We're never taught to discuss this fundamental aspect of our lives, costing us pleasure, well-being, and vitality.

This episode explores why midlife women must have open, clear conversations about sex. We'll delve into how menopause reshapes sexual health, examine cultural silence, and equip you with language and strategies to initiate vital discussions with partners, girlfriends, and yourself.

If you're seeking to reclaim your pleasure and vitality, join Gabriella at ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠www.pleasureinthepause.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ for this enlightening journey into the heart of female pleasure and empowerment.

CONNECT WITH GABRIELLA ESPINOSA:

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Work with Gabriella!

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